The school-based behavioural adjustment at 7-8 years of a cohort of 243 prematurely born, very low birthweight (< 1501 g) children and their normal birthweight controls is reported. The findings indicate that the children born preterm (both male and female) were rated by their teachers as expressing more behaviour problems than their controls, and were less well adjusted to the school environment. The deficits noted in the preterms applied across the social classes, with no amelioration noted in preterms of higher social class. It is speculated that the problem behaviours reflect a failure in self-regulatory functions.

Whether very-low birthweight (VLBW less than or equal to 1500 gm) children differ from normal birthweight (NBW greater than 2500 gm) children with respect to social (as opposed to intellectual) competence has been a relatively neglected issue. The social competence at school age of 183 VLBW children was therefore compared with that of 183 NBW children born at the same hospital matched for age, gender, social class, parity, and maternal age. A multi-informant, multidefinitional approach to social competence was adopted involving teacher, (same-gender) peer, and self-ratings of the 366 children's levels of social maladjustment, social skill, and peer acceptance. VLBW children from the upper, middle, and lower social classes received significantly higher mean sadness/unhappiness scores (even with IQ covaried) than their NBW counterparts. Mean scores for the VLBW group were also higher for social withdrawal, and lower for both social skill and peer acceptance. Possible antecedents and consequences of such group differences in affect and sociability are suggested.

Research with very low birthweight (VLBW) infants (≤isoog) may be broadly categorised into product and process studies. Recent product-oriented outcome studies are reviewed from the perspective of whether VLBW infants born since 1975 (when intensive care methods became relatively stabilised in effectiveness) show behavioural problems, intellectual impairment, linguistic or social deficits. Process studies examining cognitive, social and contextual variables, differentiating VLBW and normal birthweight infants, and thought to compromise long-term outcome are then discussed. It is argued, in the light of the conflicting evidence, that future studies need to: (1) exert greater control over the medical and psychological variables confounded with low birthweight, including the variable of social class; (2) study outcome from a life-span perspective, examining the possibility of an intergenerational cycle for at least some families; and; (3) incorporate both systems-oriented and transactional models into their designs, for the purpose not only of predicting outcome, but also ultimately for providing the most appropriate types of support for these infants.

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